Has the backlash against the participation of military psychologists in harsh interrogations of detainees at Guantánamo Bay Detention Center during the Bush era prompted U.S. doctoral programs in clinical psychology to do more ethics training to prepare graduate students for their careers?

Not according to a new study by researchers at Lesley University, Cambridge Health Alliance/Harvard Medical School and other institutions.

They sharply criticize the American Psychological Association for encouraging military psychologists to assist with interrogations and subsequently failing to require or even encourage training programs to prepare psychologists to navigate situations where there are conflicting duties to follow orders and do no harm.

In April 2015 the authors surveyed 100 directors of clinical training of programs randomly selected from the 237 accredited by the APA for their study, “Enabling Torture: APA, Clinical Psychology Training and the Failure to Disobey.”

Of the only 27 programs that responded, just 17 percent reported formally addressing issues surrounding the ethical conflicts of psychologists in military settings, reports the study published this August in Peace and Conflict: Journal of Peace Psychology, an official APA journal.

“I don’t really put responsibility on the individual programs, I put responsibility on the APA. That’s my opinion. APA is responsible to accredit programs,” said lead author Alice LoCicero, Ph.D.

She closed her private practice in Cambridge, Massachusetts, over the summer and is now a visiting scholar at the Wright Institute in Berkeley, California for the 2016-2017 academic year.

The study’s publication date came the day after the APA’s 124th Annual Convention held Aug. 4-7, in Denver.

During the convention, APA members debated whether military psychologists treating other military personnel at Guantanamo could also provide treatment to detainees. Current policy does not authorize them to do so but allows for non-military psychologists to treat detainees if they are working for the detainee or for an independent third party to promote human rights.

LoCicero, who attended the convention, observed the many military and veteran-related booths in the Exhibition Hall, including recruiters from the U.S. Army, Navy and Air Force.

One in eight psychologists in the U.S. work for or with the Department of Defense and one in four psychology intern applicants are matched with a Veterans Health Administration internship, LoCicero said.
She noted that potentially any clinical psychologist could end up working for the DOD under the Health Care Personnel Delivery System adopted by Congress in 1987 as a plan to draft civilian clinical psychologists between ages 20 and 45 into military service.

In July 2015, an APA-commissioned independent report led by Chicago attorney David H. Hoffman concluded that APA and DOD officials had colluded to establish permissive APA ethics policies supporting the torture program under President George W. Bush’s “war on terror.”

The APA Council of Representatives then passed an historic ban on the involvement of psychologists in settings that operate outside or in violation of international law, including Guantánamo.

But military psychologists and other groups within APA are trying to roll back the new policy to put psychologists back in Guantanamo and elsewhere.

Before launching the study, LoCicero contacted three programs that posted their ethics course syllabi on the Web site of the APA’s Division 2, The Society for the Teaching of Psychology, to ask if the coursework addressed psychologists’ roles in military interrogations.

“They all said the same thing,” LoCicero said. “They just don’t have time to prioritize it, that they felt there were other things that were more commonly encountered by more of their students and so they were focusing on the things that they felt were everyday matters.”

The researchers write that they did not poll all 237 APA-accredited clinical psychology doctoral programs “because we believed there was a risk APA would object to our survey.”

Asked if they were paranoid, LoCicero replied: “I understand your question. People can say paranoid. I don’t think anybody was out to get us, but I don’t think APA would have necessarily been very happy to see these questions put out to the directors of clinical training.”

LoCicero said the authors promised absolute confidentiality to those who responded to the study. She thanked the journal’s publisher, APA Division 48, The Society for the Study of Peace, Conflict and Violence: Peace Psychology.

“I think it was courageous of the journal to publish it,” she said.

“This is not a great finding. It’s not a happy finding,” LoCicero added. “The good news is we don’t think this particular thing is going to be impossible to remedy.”

The study recommends ways to address the gap in ethics education and stop torture from happening in the future.

They include referencing APA’s new “Standards of Accreditation for Health Service Psychology” to guide the systematic inclusion of ethics throughout the curriculum.

Professors can teach the history of APA’s relationship with the DOD and Central Intelligence Agency and educate students to both identify the values embraced by military culture and those in a social justice approach to ethics.

The authors say it would be beneficial for students to engage in debates about a dilemma and then switch sides halfway through to argue for the other side.

The new Standards of Accreditation includes a requirement that all students and trainees develop skills leading to ethical decision making as one of nine profession-wide competencies (PWCs). In response to an inquiry from New England Psychologist, APA’s Communications Group replied with the following statement:

“The PWCs do not require programs to deliver specific types of training, but provide programs with the opportunity to implement education and training that will deal with the multiple types of situations for which those trained in health service psychology might encounter. Given the diversity of such situations, training at the doctoral level in accredited programs is grounded in the ethical principles of the profession, as well as laws and regulations that are relevant for a range of practice settings. Such training is related to all possible career paths that the profession offers.”